ECE2018 Poster Presentations: Pituitary and Neuroendocrinology Neuroendocrinology (28 abstracts)
Recurrence of hyperprolactinemia after dopamine agonists withdrawal
Cristina Contreras Pascual , Paloma González Lázaro , Julia Silva Fernández , Inés Gómez García , Belvis María Torres Arroyo , Florentino del Val Zaballos , Francisco Javier Gómez Alfonso & Álvaro García Manzanares Vázquez
Hospital la Mancha Centro, Alcázar de San Juan (Ciudad Real), Spain.
Introduction: Prolactinomas are the most common tumors among functional pituitary adenomas and they constitute 40% of all pituitary tumors. Dopamine agonists (DA) are considered the primary treatment of prolactinoma. DA can lead to complete remission (including eradicacion of the tumor), allowing discotinuation of treatment. So far, there aren’t clinical criteria with sufficient predictive value for long-term remission.
Objective: To assess the effect of DA withdrawal, the current recurrence of hyperprolactinemia, and posible factors that predict recurrence.
Patients and methods: We evaluated DA withdrawal in 16 patients with prolactinoma who received DA for at least 2 years with normalization of prolactin levels. Factors that predict recurrence were evaluated.
Results: Sixteen patients (fifteen female and one male) aged between 47 and 27 years at diagnosis were analyzed. Seven patients showed recurrence after dopamine agonists withdrawal while nine remained without dissease signs or symptoms. The most frequent indicator of recurrence was asymptomathic hyperprolactinemia (85%).
| REMISSION (9/16) | RECURRENCE (7/16) | p | |
| SEX (FEMALE) | 9/9 (100%) | 6/7 (85.7%) | ns |
| SELLAR ADENOMA | 7/9 (77.7%) | 5/7 (71.4%) | |
| MICROPROLACTINOMA | 7/9 (77.7%) | 5/7 (71.4%) | |
| TUMORAL MASS REDUCTION >20% | 3/8 (37.5%) | 4/7 (57.1%) |
| Remission group | Recurrence group | p | ||||
| AVERAGE | ± | AVERAGE | ± | ns | ||
| Age at diagnosis (years) | 35.47 | 8.33 | 41 | 6.19 | ||
| Baseline PRL levels (ng/dl) | 214.94 | 209.94 | 333.64 | 515.84 | ||
| PRL levels after treatment (ng/dl) | 14.92 | 12.74 | 21.70 | 28.91 | ||
| Initial treatment dose (mg/week) | 6.28 | 7.71 | 2.41 | 3.33 | ||
| Adenoma diameter (mm) | 7.74 | 2.81 | 10.42 | 9.18 | ||
| Time to treatment withdrawal (months) | 36.12 | 25.62 | 18.71 | 14.10 | ||
Conclusions: The sample is too small to achieve significance but baseline tumor size, baseline PRL level, initial treatment dose and time receiving DA seem to predict recurrence. Significant reduction in tumor size, sex and age don’t seem to predict the risk of recurrence.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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